Pain Management Community

OMG, Swank!

This is tremendously disconcerting.

Thanks for posting,

CTB

I actually don't see where this is a huge deal. The ER is only meant to quickly assess whether someone is in a life or death situation and then send them to see their own Physician.

Restricting the medication to only be a supply for 3 days seems perfectly fine as well as not replacing lost or stolen meds.

As well as not giving them Methadone or OxyContin. It's not their job to be giving out long acting meds like this as they are not treating those patients for chronic pain as it's not their job.

Any of us would not, or should not be negatively affected by this as we have our own Drs. who prescribe our pain medications and if we need to be seen in the ER, our own Drs. would/should know about this as well.

So, I, personally don't see how this is disturbing. The only people this affects are those who are using the ER as their "primary" Dr. and trying to get long term treatment which is not acceptable. Or those who come in lying about lost/stolen meds....which again, for someone whom this really happened to, that should be handled by the police and someone's regular prescribing Dr.

I know some people start to get upset at "any" regulations by tthe states and/or the federal government but I look at everything very carefully and make my own determination based on the facts and I just don't see this being anything negative for chronic pain patients.

I urge those to read the whole article. (I didn't click on the provided link but read it on a news website.).

It's most certainly going to effect people that have real emergencies. Say you end up in the ER due to an auto accident or any kind of accident with a broken limb or worse. Are you really okay with telling those people they can't have painkillers? They're not just talking about chronic pain patients. Doctors should be the ones deciding who gets pain meds, not the mayor.

My niece ended up in the ER a couple weeks ago with a leg that was broken in two places. She was in agony. Thank God she wasn't in NYC!

I agree that pain meds should be given by the doctors involved in their care, not by politicians. I think the people of New York City have some say in all this, at least indirectly by who they elect to public office.

I think it mainly affects people who are medicaid or uninsured people who use the ER as their main point of access to health care. The rest of us would be referred to our own doctors for post ER care, those folks have no money to pay for their own doctors. Back when I worked in the ER as an RN, many folks used the ER as their primary care doctor. Our doctors were fairly giving with vicodin and oxycodone, (short acting drugs), but never prescribed long acting drugs like Oxycontin or methadone.

Guess what, nobody came in and said their high blood pressure meds had been stolen or "fell in the toilet" (a common complaint), this only happened with opiate type pain meds for chronic pain. Not gabapentin, or other drugs commonly prescribed for chronic pain.

Who knows? I would rather err on the side of giving opiates to an addict, than not giving them out to chronic pain patients. Everyone has an opinion on this.

Take care, Annette

Using the ER as one's primary care doctor IS unacceptable, but what exactly is one to do if they have symptoms that require medical attention and they do not have the money to be seen at time of service? Using the ER is their only choice. This is what we need to change.

We agree 95% of the time.

Take care, Annette

First, of all, this does not mention giving pain meds that are used in the ER itself, just giving out-patient meds for three days after care in the ER.

Since I am unfamiliar with the dispensing/prescribing habits in NYC ERs, or any on the East coast for that matter, I should not even comment on this. In the states I have worked in in the Western US, the ER doctors wrote RXs for anything but the night shift the day of injury, so short acting pain meds were confined to two or three doses at the most, and a paper RX was giving for anything else or if the patient were discharged during the open times of the pharmacies. There were no open 24 hour pharmacies available for about five years that I lived in Reno, once they were open, it was hard to get anything besides paper RXs from the ERs.

I would not wish to be anywhere where politicians decided how much pain meds we get. Thank goodness, this is Bloomberg's wish, not fact yet. The people in NYC need to decide what to do.

Take care, Annette

I haven't had health insurance in over 6 years....I am on food stamps/SNAP, and have had to sell everything I own...So, I am one of "those" people but I have never used the ER in that manner.

(Response in general not directed all to Annette:))

PLEASE read the entire article....

The point of this bill is not to deny anyone care or getting help with pain. If someone has an accident and they are taken to the ER they will get proper care...They just won't be given more than 3 days worth of opiate pain medications AT A TIME....

If the ER Dr. is dismissing a person and they do not have any type of Dr. they can see for follow up then this will not preclude them from coming back and to be seen as directed by that Dr. and then can get more care.

So...the new regulation does NOT say that NO meds will be given to anyone who comes into the ER!....

And as far as the not replacing stolen or lost meds...this is perfectly reasonable to me. Same thing with not prescribing the OxyContin or Methadone. Again....this shouldn't be done anyway for an acute pain episode.

I hit the reply button 3 different times on Annette's post and it keeps putting me replying to Swanks????

Oh well..LOL...It's really a quick response to Annette's first paragraph and then the rest is in general...

We all can certainly agree to disagree on this particular subject...

I hate not being able to edit! LOL...

Just wanting to add that this is not restricting them giving someone an IV of pain medication while they are in the ER or if they need to be admitted, or sent to another part of the hospital...

It's all about "discharging" someone from the ER, which that means usually someone is not in a critical situation, with no more than the 3 days of opiates...

I know that even for me at age 44, I have gone to the ER twice in my life and back then, even for the most major of surgeries....you were given no more than a weeks worth of Percocet 5mg...

Things really have changed drastically to where so many people "demand" or expect opiates for every single pain they have when that is not always the best medication for their type of pain. And people see that others are on certain types of opiates so they expect the same thing right off the bat if they have back pain, even a sprained ankle, etc..

I am NOT saying that there isn't a need for strong pain medication but we really do have an epidemic of prescription drug abuse in this country..Not just opiates but other controlled substances like Valium or Adderall..

The statistics for NY are fairly staggering with the 143% rise between 2004 and 2010 pain killer emergency room visits...

In NYC alone, two million opiate prescriptions are written each year...

Again, I am not someone who thinks Government should be involved in every detail of our lives....As I wrote earlier, I try to look at each thing in itself and see whether I agree or don't agree as I am in Independent when it comes to everything.

For instance without going far off tangent..I vehemently disagree with the new FDA regulations saying that ALL women need to have their Ambien dosages cut in half because "some" people are not giving adequate time between taking it the night before and then doing something dangerous like driving.

So, I hope that as I wrote in my other post that this thread doesn't become a personal argument but a healthy discussion for everyone on here:)

Bloomberg is a hypocritical ASS!!! Sorry, but he is. People like that, make me want to slap them right in the mouth. He is beyond DESPICABLE!!! Another wonderful rich person, caring for the little guy. Yeah, right! How can rich, suppossedly well educated people, be so incredibly stupid???

Another "BLOOMBERG" moment!!!

Thanks, Swank!!!

Dennis

I don't see this is as being an issue.

At first read, I was upset. Now that I've re-read the link and considered other thoughts on the topic, I have to say that my initial concern was a bit-too much.

I am no longer disturbed in any way about this mandate.

Sorry for the fuss.

Regardless of what the mandate says, the fact that a politician is telling doctors what they can and cannot prescribe should be disturbing to everyone. Regulations are driving some great doctors out of the profession already.

The disturbing part for me is the fact that MANY abuse the pain pills, down to teenagers...